Perimenopause in Ethnic Minorities: Why Symptoms Are Missed | The Forties Formula

Perimenopause symptoms often present differently in Black, South Asian and East Asian women. South Asian women typically reach menopause between 46 and 48, compared with 50 to 51 in Caucasian women, meaning symptoms can begin in the mid-thirties. Symptoms are more likely to appear as joint pain, body aches, anxiety, insomnia, vaginal dryness and recurrent UTIs rather than hot flushes. Black women in the UK are approximately five times less likely to be prescribed HRT. In this episode of The Forties Formula, Jasmin Dhillon and Amanda Lim sit down with Dr Shahzadi Harper to explore how perimenopause affects women differently across ethnicities, and why that matters for diagnosis, treatment and long-term health. They cover why perimenopause can start earlier than most women realise, the higher baseline cardiovascular, metabolic and bone density risks carried by South Asian and Black women, and why East Asian women are wrongly assumed to sail through menopause symptom free. Dr Harper shares her own perimenopause story, including brain fog, fatigue and joint pain with no hot flushes at all, and why she chose HRT and testosterone. The conversation moves into GLP-1s and metabolic health, how to advocate for yourself when a doctor dismisses you, what to do if you cannot or do not want to take HRT, and why common symptoms should never be accepted as normal. Finally, Dr Harper shares her Forties Formula: put yourself first. CHAPTERS 00:00 Why perimenopause is misunderstood 01:53 An ethnic minority lens 06:06 Do clinicians know? 08:02 The hardest stage 13:54 Dr Harper's own story 16:06 Why she chose HRT 17:44 GLP-1s and perimenopause 21:19 Stress, caring and weight 25:58 Metabolic and heart risk 30:57 Access and awareness 33:13 Advocating for yourself 36:23 The many symptoms 40:47 If you can't take HRT 47:38 Stop white-knuckling it 49:16 Relationships and identity 51:32 Her Forties Formula FREE DOCTOR SCRIPT Feel dismissed at your appointment? We have created a free script with exactly what to say and which tests to ask for. https://the-forties-formula-with-amanda-jasmin.kit.com/script ABOUT OUR GUEST Dr Shahzadi Harper is a GP of over 20 years and founder of The Harper Clinic on Harley Street, specialising in women's health, perimenopause and menopause. ABOUT YOUR HOSTS Jasmin Dhillon is an Integrated Health Strategist and Health Coach helping women in their 40s navigate gut health, hormones and nutrition. https://www.instagram.com/eat.with.jasmin/ Amanda Lim is a Metabolic Health Coach focused on helping women build strength, confidence and long-term health. https://www.instagram.com/coachamanda/ SUPPORT THE PODCAST Subscribe and share this episode with a woman who needs more support through perimenopause. You can also buy us a coffee: https://the-forties-formula-with-amanda-jasmin.kit.com/products/buy-us-a-coffee OUR SPONSORS Love Indus. Code TFF for 21% off. https://loveindus.com Perimenopause symptoms, perimenopause symptoms age 40, symptoms of perimenopause, perimenopause treatment, perimenopause anxiety, HRT, menopause age by ethnicity, women's health, midlife health.